Constipation occurs when bowel movement become less frequent (fewer than three bowel movements a week), and stool becomes difficult to pass. This is often due to changes in diet, routine, or inadequate intake of fiber. Constipation tends to start as early as progesterone levels rise, during the second to third month of pregnancy. It may get worse as pregnancy progresses and your uterus grows.
What are the causes of constipation?
The cause of constipation during pregnancy depends on the stage at which it occurs. Possible causes include:
Progesterone: Pregnancy hormones are the culprit behind constipation. Progesterone causes the muscles in your bowels to relax, allowing food to hang around longer in the digestive tract.
Prenatal vitamins: Prenatal vitamins are full of iron, a crucial mineral that can sometimes be deficient during pregnancy. Iron can cause constipation and hard, black stools.
Pressure from the uterus: During the later stages of pregnancy, the growing uterus can put pressure on the bowel, making it harder to move stool through the intestine.
Lifestyle: The amount of fluids you drink each day, and how much exercising you do all play a role in making you constipated. Pregnant women who do not eat enough fiber, drink enough water, or get enough exercise to help their digestive system move waste out of the body, suffer from constipation.
How to manage constipation during pregnancy
There are many ways that you can relieve yourself from the symptoms of constipation during pregnancy.
Increase fiber intake - Fiber-rich foods help you eliminate waste, so aim for 25 to 35 grams each day. Eat plenty of whole grain cereals and breads, legumes, fresh fruits and veggies (raw or lightly cooked — preferably with skin left on), and dried fruits.
Reduce the amount of refined food - Try to avoid refined grains (white bread, white rice, refined cereals and pasta) when you can, these may cause constipation.
Increase the amount of water - Drinking as much as between eight and 10 glasses of fluids (water, vegetable or fruit juice and broth) every day keeps solids moving through your digestive tract and makes your stool soft and easier to pass. If you struggle to drink the required amount of water, consider warming the liquids and adding lemon, to help stimulate peristalsis (the intestinal contractions). Prune juice is a good addition to water since it is a mild laxative.
Avoid eating large meals - Big meals can overwhelm your digestive tract, leading to constipation. Try eating six small meals throughout the day rather than three large ones.
Consider supplements and medications - Many of the supplements and medications that do a pregnant body good (prenatal vitamins, calcium and iron supplements, and antacids) can exacerbate constipation. Ask your medical doctor about alternatives (such as slow-release iron supplements) or adjustments in dosages until the situation improves. You may also ask your doctor about taking a magnesium supplement to help fight constipation.
Increase your probiotics - The probiotic acidophilus, which is found in yogurts contains active cultures. These stimulate the intestinal bacteria to break down food better to improve the movement of bowel.
Regular exercise - Exercise during pregnancy encourages regular bowel movements. Even just a 10-minute walk can help, so make sure that you are getting the recommended amount of appropriate exercise.
Importantly, stay away from stimulant laxatives. Not all laxatives and stool softeners (especially herbal or homemade ones) are safe for use during pregnancy. Talk to your doctor before taking any constipation medication or remedy.
When to see a doctor
It is important to consult with a doctor before taking any medication, including laxatives or other constipation remedies.
It is also advisable if any additional symptoms occur, including:
nausea
stomach pain
vomiting
constipation that lasts for longer than 1–2 weeks
bleeding from the rectum no relief after using a laxative
Take Home Message
Constipation is a common condition during pregnancy. You can exercise and increase fiber intake to improve symptoms.
This article is written by Dr. Itumeleng Buti (MBChB)
References:
1. Amy O’Connor. Constipation During Pregnancy. [Internet] What to Expect. [updated 2020 October 21; Cited 2022 April 19] Available from: https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/constipation.aspx
2. Nicole Galan. Constipation and pregnancy: What to know. Medical News Today. [Updated 2019 February 6; Cited 2022 April 19] Available from: https://www.medicalnewstoday.com/articles/324379.
3. Cleveland Clinic. Pregnancy Constipation. [Internet] [Updated 2019 October 19; Cited 2022 April 19] Available from: https://my.clevelandclinic.org/health/diseases/21895-pregnancy-constipation.
4. Cullen G, O'Donoghue D. Constipation and pregnancy. Best Practice & Research Clinical Gastroenterology. 2007 Oct 1;21(5):807-18.
5. Trottier M, Erebara A, Bozzo P. Treating constipation during pregnancy. Canadian Family Physician. 2012 Aug 1;58(8):836-8.
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